***Many conservatives are statists.
Posted on 02/12/2022 4:40:10 AM PST by Kaslin
With revolutionary vaccines being developed in near record time, healthcare and the pharmaceutical industry have figured prominently in news coverage during the coronavirus pandemic. These life-saving vaccines have been offered at little or no cost to citizens. However, prior to the pandemic, the cost of prescription drugs for all maladies was a concern for many Americans. It is also likely to be a constant concern in the future.
According to polling data from the Kaiser Family Foundation, more than 80 percent of Americans describe the cost of prescription drugs as “unreasonable.” Further, another 31 percent say they actively have a difficult time affording their prescriptions, with 29 percent saying they’ve either foregone a prescription or skipped doses to avoid high costs. This is not an isolated problem, and one that could carry weighty consequences for all families.
A large part of the reason for these high prices is the perverse incentives the current system offers to pharmacy benefit managers (PBMs). These entities negotiate between drug companies and insurance companies. They also have a large say over which drugs end up on formularies. Thus, they play an outsized role in the pharmaceutical ecosystem.
Insurance companies reimburse PBMs based on how much of a discount they can negotiate with the drug companies. While this structure is supposed to incentivize PBMs to find discounts and drive down prices, in actuality it does the opposite. Because they are paid based on the difference between the list price and the negotiated price, PBMs are better served if they focus on drugs with incredibly high list prices. That way, they can more easily secure a bigger “discount” and get paid more by insurers.
Given that drug companies know how much influence PBMs have over coverage decisions and formularies, they are thus incentivized to raise their prices to make themselves more attractive to the PBM. For example, A PBM would much rather choose a $500 drug that can be negotiated down to $300 than a $50 drug that can be negotiated down to $30. Even though the latter drug is ten times more affordable, PBMs would miss out on a big reimbursement from insurers.
Besides driving drug prices higher, this scheme leaves patients behind in another way. Many insurance plans require patients to pay for medications at the full list price until hitting a deductible, or a percentage of the list price until a certain point. Those discounts that the PBMs negotiate are often not passed to consumers, nor are PBMs required to disclose how those negotiations proceeded. In short, the cards are stacked against patients in almost every way.
This lack of transparency is one of the fatal flaws of the system and provides patients with little recourse. However, businessman, TV personality, and Dallas Mavericks owner Mark Cuban is seeking to expose that system and create a better way. Last week, Mark Cuban launched the Mark Cuban Cost Plus Drug Company (MCCPD) as an online pharmacy. This PBM operation offers low-cost generic medications to patients and emphasizes transparency.
MCCPD is transparent about how much it costs to manufacture, distribute, and market its products. Their stated mission is to ensure there are no hidden costs or anything that goes on behind closed doors that is not equally offered to patients.
This transparency is key to lasting solutions for drug pricing and availability. Patients deserve to know if the medications they are taking are being offered to them because they are the best available or because they offered the sweetest deal to a PBM. The “savings” attained by PBMs behind closed doors ought to be passed on to patients, rather than making them pay the fictionally high list price.
Market-based and transparent solutions like Cuban’s PBM are the first step towards addressing the problems with traditional PBMs. MCCPD is still a small operation, which will not overhaul the entire system… yet. Lawmakers should look towards his example to bring about lasting change. Unfortunately, many in Congress are bogged down with unserious solutions that involve restrictive price controls on medications, which will only serve to reduce supply, investment in research and development, and delay access to care. Even worse, the Biden administration is set to delay the implementation of a Department of Health and Human Services (HHS) rule that would guarantee some degree of transparency for PBMs.
The market has identified a core issue with the drug pricing system. Leaders in Congress need to let transparency and market forces drive any legislative solution. Entrepreneurs like Mark Cuban are also integral in providing alternatives to the warped incentive structure we see today and lawmakers also must ensure that the regulatory framework is such that people like him can continue to do so. This is the way forward.
Dan Savickas is the Government Affairs manager at Taxpayers Protection Alliance.
Anybody notice how cheap laser eye surgery is? It’s not insured so they have to compete on the open market. Maybe if drugs were not covered by insurance we might see something similar.
My wife and I are 68 and my blood pressure has hovered around 162 over 102 for over a decade. We’ve not been to a pharmacy in over a decade either*. But we do take suplements and watch our diet (no fast food in over two decades, and I see donuts as worse than cigarettes, literally).
I am shocked at the lines at the pharmacy area of my local Kroger’s. I think our nation is becoming addicted to prescription drugs. Just say no!
*This ma be because I’ve not been to a doctor appointment in over a decade either.
Did everyone forget Trump was lowering drug costs?
Best way to punish for their criminal behavior.
Nope. Insulin pricing reform had lowered patient costs and was repealed almost immediately by Brandon. Oddly enough, up until this Januarys report, branded drug costs actually decreased over the last few years. Because there has been no PBM and middleman reforms, that savings is not passed on to the consumer. There are multitudes of copay assistance programs available but the PBMs who manage employer drug plans are now encouraging them to put in place copay accumulator and maximizer programs which prevent the help a patient gets from counting toward their out of pocket spend. I encourage anyone who is interested to look at Adam Fein and his Drug Channels site.
XIFAXAN® (rifaximin) for SIBO is $1,350 to $1,250 for 2 weeks. Besides Bacterial over growth in the small intestine it’s used to treat Traveler’s Diahrrea. As hub is Ret. USN SCPO we use the Navy base Pharmacy, it’s Free. Took 3 rounds to clear the SIBO bout. It is so expensive that Tricare Life won’t let a private Pharmacy fill it, base has it, so must be a fairly commonly used med. My Humalog for 3 months is about $40 from Express Scripts. Supplies can be free at the base. Base uses Novalog. I did well on the Humalog, so the ENDO was happy to continue it’s use, rather that switch and risk a reaction. The 1 catch that Robert Yoho, Ret. MD, surgeon, writes in his book BUTCHERED BY HEALTHCARE, is the Military buys up case lots of about to expire meds, the reason they can offer them free.
He also says METFORMIN IS WORTHLESS for Diabetics, as are the other pill forms. I have to agree with him, My eldest who will be 51 next month had to take both Metformin and Glimerpride. And still his A1C1 didn’t change, nasty side effects. I used less one month and had him try my Humalog, His A1C1 was down in 3 months. Never happened on the pill forms, Better control, as you can up a few click for a BS upswing. Or lower it if you need to, as I react to a lot of meds, the only side effect was a lower A1C1 and more potty trips, because I also take a heart/fluid pill. Triamterene/hctz 37.5/25 (Dyazide) that I can only get through Express Scripts. Pyfzer bought out Mylan for billions, who made the 1 I took. So I had to go with Express Scripts, who has to go outside the TN region of Pensacola for it’s replacement.
Between the covers of the 3 books you will learn all the dirty, shady, fradulent tricks Pharma, FDA, CDC, Congress PULL.
Read his book you will understand WHY prices are so high. Between bad research, fraud, congress payoffs, sales reps, TV ads makes them cost more. Only USA and New Zeland allow TV ads on meds. Ads make you want the new Expensive drugs. Crestor made itself #1 that way, there are older cheaper generics just as good with less side effects. IT’S A COMPLETE RACKET, and it gives you men like Fauci.
In fact you will understand RFK JR Fauci better if you read Yoho’s book first. He does mistate Fauci has known Gates 20 yrs. Faustian Bargain by Steave Deace’s book says they were Cornell roommates.
https://smile.amazon.com/Faucian-Bargain-Powerful-Dangerous-Bureaucrat-ebook/dp/B0917PZ3D3/ref=sr_1_1?crid=37DV8MS20SYKN&keywords=faucian+bargain+steve+deace&qid=1644672908&sprefix=steave+deace%2Caps%2C102&sr=8-1ve
You just have to get past his INBRED DEM HATRED OF TRUMP AND GOP. REST IS FACT. With a lot of links. So are the other 3 books.
Plaquenil is the name brand for the chemical name of HCQ OR Hydroxychloroquine been on the market for 55 yrs, as RA/LUPUS/MALARIA drug. Patients still use the brand name instead of the tongue twister generic. STROMECTOL is Ivermectin approved for humans in 1997. Bought OTC in Third World countries.
The 1 to stay away from is the Fauci killer drug VEKLURY® (remdesivir), it is an ORGAN DESTROYING DRUG, ESP. TO COVID VENT PATIENTS. The reason most die. Gilead only did 1 very controlled study, where as and I hate giving China any credit, did a double blind random study, showing how destructive VEKLURY® (remdesivir) reallky is. And Vent patients are already on Anesthesia meds that slow heart rates down, shallower breathing.
STOP USING THE CHEM NAMES, USE BRAND NAMES when you mention them. Most won’t know you are talking about the better meds. And if you think about it it is just another CON GAME. CALLING A HUMAN DRUG A HORSE DEWORMER WHEN IT IS NOT, LETS THEM GET AWAY WITH IT. STROMECTOL if looked up states for HUMANS. Yes it’s going to clean out the intestines. 80% of your immune system is in your GUT. PROBIOTICS IN THE MULTI STRAIN BILLIONS NEED REPLACING, AFTER YOU CLEAN OUT. Goes for Colonscreen Clean outs too.
Plaquenil and Veklury the same way. Words have meaning, in this case life or death.
$5,000 is a lot of money. We paid that to fix my badly done 1 catract surgery. It is considered a Cosmetic surgery, thus even if it’;s a medical necessity ins doesn’t have to cover it.
And you can bet the farm Tranny surgery, hormones Will be covered.
“ All Pfizer profits should be routed to Medicare this year.
Best way to punish for their criminal behavior.”
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How very Leftist of you.
Hey, while we’re at it and being Progressive, let’s punish the gun manufacturers too for all the death they cause.
And GM, Ford, Chrysler………they need to be punished for all the accidents their products create.
Oh, and Wall Street…….the evil rich people make money off the backs of working class.
Pfizer makes many medications of which many keep people alive and able to live a more normal life.
Just because you believe the B.S. being tossed around by Blogs for profit and Unverified Twitter accounts doesn’t mean it’s true or that Pfizer broke any laws.
What happened to Conservatives? They sound more and more like Leftist.
I take 4 meds, all essential, like you big on Vit/Mins, and Probiotics. I take indvidual bone ones, and the Covid protocol with Quercetin, added in Quinine Bark to boot. Just upped the D3 as it is part of the bone vits. Zinc I usually take I doubled. I learned a lot reading Earl Mendell’s Vitamin Bible when I was younger. Reversed OP back to Osteopenia, all but 3 bad areas. Drugs hate me, jump for joy.
“ Did everyone forget Trump was lowering drug costs?”
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Apparently.
The thing is, most people have insurance covering their prescriptions.
If they don’t, most States will help with the cost. Even the Drug Companies the s selves offer programs for fixed incomes.
Some people won’t be happy until it’s all free……..even so-called conservatives.
Fixed prices are, ipso facto, unreasonable. All prices for pharmaceuticals, and most prices for medical services, are fixed by "negotiators" (hospitals, "insurance" companies, PBMs, and the government) who are in fact allies in a joint enterprise to take from "the rich" (employers and taxpayers) to give to "the poor".
Yeah because I object to misleading and false information from people that are making money off scaring the crap out of people but regardless of me being against any Covid type mandates, you label me as you did.
Like I said. Just like a Leftist……..except I’m not labeled a racist, but a vaccine pusher.
Are the Canadian Truckers vaccine pushers too? 90% are vaccinated and they’re against mandates also.
More and more understand Tenpenny, Malone, Kirsch, et al are in it for themselves.
They’ll sell you the Bombshells and you eat them up.
You and I are on a similar vitamin regimen.
Price controls equates to shortages. If big pharma can’t profit from its research, they won’t produce.
“you label me as you did”???? I was aGREEing with you.
My apologies.
I didn’t fully understand the meme.
Forgive me for being overly sensitive………it’s been a long pandemic.
Soon to be over though.
No big deal. Just be sure to wear your mask while FReeping, you know... to be triple-sure against viruses.
THEY are the reason that therapeutics like Ivermectin were suppressed.
With effective therapeutics available, Pfizer would not have been able to receive EUA for their ineffective and dangerous "vaccine".
Not only was their research ineffective, it was criminal in the negative data that was withheld.
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